Under the umbrella of epistemic injustice communication and epistemic injustice in clinical encounters: a critical scoping review

Abstract

Introduction

Concordant communication between a patient and healthcare practitioner is a critical proponent of effective care. Prejudiced communication from healthcare practitioners creates vulnerability for Epistemic Injustice and is a barrier to Culturally Safe Care. The language used to detect, address and mitigate instances of Epistemic Injustice during clinical interactions is currently unknown.

Objective

This review seeks to address this gap by assessing current understandings of Epistemic Injustice during patient-healthcare practitioner clinical interactions and suggest pathways to promote health equity policy.

Methods

This study utilized Arksey and O’Malley’s scoping review methodology and Grant and Booth’s critical appraisal framework to review articles from four databases: WEB of Science, SCOPUS, PsycINFO and Medline. Following a literature review to inform inclusion criteria, studies were assessed for detectable themes of Epistemic Injustice in relation to patient-healthcare practitioner communication during clinical encounters.

Results

Initially, 2729 studies were identified, and 44 studies were included. Two major themes are discussed in this review: (1) Types of Epistemic Injustice and (2) Counterparts of Epistemic Injustice.

Conclusions

Currently, literature does not directly discuss experiences of clinical Epistemic Injustice, rather discussion occurs across a network of similar linguistic identifiers, which hinders detection and subsequent mitigation of Epistemic Injustice in clinical settings. By modeling a definition for clinical Epistemic Injustice, educational resources from which patients, practitioners and policy developers alike can draw from are suggested. Basing future mitigation strategies on these findings supports pathways to reducing health disparity, especially for marginalized communities, and promoting equity.